Low conductivity irrigating solutions for arthroscopy

The purpose of this study was to find a nonconductive physiologic solution to use for arthroscopy when electrosurgery is performed. We studied the effect of several solutions on proteoglycan synthesis in bovine articular cartilage slices, and the effect of using an electrosurgical instrument in various solutions in bovine knee joints. Both HEPES buffer 0.3 M (N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid) (Sigma Chemical Company, St. Louis, Missouri) and glycerol 2.6% gave good results in both categories. The glycerol solution appears to be the best from those tested since it supported cartilage metabolism somewhat better and is far less expensive than HEPES solution. Thus, in the use of electrosurgery during arthroscopic procedures, solutions such as Ringer's lactate and saline are too conductive to be effective or safe. Distilled water is nonphysiologic. Glycerol 2.6% is safe and effective and supports articular cartilage metabolism reasonably well for up to 2 h.